Prepopulating clinical events with image based documentation

ABSTRACT

Systems, methods, and computer-readable media having computer-executable instructions embodied thereon for protocol driven image acquisition are provided. In embodiments, a protocol is received by an image capturing device. The protocol comprises orders from a clinician, a workflow for capturing at least one image, or a combination thereof. At least one field for receiving metadata to be associated with the at least one image allows structured documentation to begin on the image capturing device. The at least one image and associated metadata are communicated to a medical information system. A patient is identified by the metadata or an existing patient to device association and the at least one image is associated with an electronic medical record for the patient.

RELATED APPLICATIONS

This patent application is a continuation of and claims priority to U.S.patent application Ser. No. 13/957,627 (Attorney Docket No.27098.189886), filed Aug. 2, 2013, which is a continuation of and claimspriority to U.S. patent application Ser. No. 12/982,151 (Attorney DocketNo. CRNI.157840), filed Dec. 30, 2010, both of which are incorporatedherein by reference in their entirety.

BACKGROUND

In recent years, healthcare service providers have been making thetransition from manual paper-based medical records to an electronicformat. Commercially available computer software, such as PowerChart®,PowerChart Office®, and other Cerner Millennium® applications marketedby Cerner Corporation of Kansas City, Mo. have advanced the state of theart well beyond the conventional manual approach. Electronic-basedrecords substantially increase the efficiency of healthcare providersand institutions. Electronic medical records also substantially reducerisks associated with high volumes of patient data and potentialliabilities arising out of clerical errors or misinformation. Theelectronic format enhances communication between various providers andwithin institutions. As electronic clinical documentation continues tobecome increasingly prevalent, the variety of applications, electronicforms, electronic charts, and user interfaces, as well as thecorresponding versatility of this format, continue to expand.

Images are commonly used by physicians and other healthcare providers tomemorialize relevant image-related information associated with patientinteractions. In many cases, images provide great insight into thepatient interaction, particularly when accompanied by supportingdocumentation. For example, the patient may be a burn victim or have abroken bone. Images are often captured by someone other than a physicianand orders must be sent from the person responsible for capturing theimages (hereinafter, the “photographer”). Images can be captured in manyforms, such as by a digital camera, a handheld scanner, or other medicalimaging device. Hard-copy images can be mislabeled or lost, and are notan efficient means of preserving image data that is to accompany medicalrecords. Even electronic image files present challenges as they stillmust be imported, attached, or otherwise appended to existing records.Similar problems can arise with misidentification and mishandling ofthese unassociated electronic files within vast medical informationsystems.

Many currently available forms of image capturing devices are limited intheir ability to add image related documentation to the image file. Forexample, conventional digital cameras do not allow a user to associateclinical documentation with the actual image. Similarly, conventionalimage capturing devices do not integrate with protocols to provide theuser with a set of instructions to fulfill the clinician's orders. Inaddition, conventional electronic medical records are unable toassociate an image with a specific portion of a patient's medicalrecord.

SUMMARY

Embodiments of the present invention relate to systems, methods, andcomputer-readable media having computer-executable instructions embodiedthereon for performing a method in a computerized healthcare system, andcomputer systems for medical image acquisition and documentation. In oneembodiment, the method includes decoding a barcode associated with apatient. The barcode includes information associated with the patient.At least one field is populated with metadata derived from theinformation. At least one image of the patient is then captured and themetadata is associated with the at least one image.

In one embodiment, the method includes communicating a protocol to animage capturing device for taking at least one image of a patient. Theprotocol comprises orders from a clinician, a workflow for capturing theat least one image, or a combination thereof. The at least one image andthe associated metadata are received into a medical information system.A stored patient associated with the associated metadata is identified.The at least one image and associated metadata is stored in anelectronic medical record for the patient.

In one embodiment, the method includes receiving a protocol forcapturing at least one image of a patient. Information associated withthe patient is received. A protocol for capturing the at least one imageof the patient is displayed. At least one field is populated withmetadata corresponding to the patient. The metadata is associated withthe at least one image and is transmitted, along with the image, to anelectronic medical record (“EMR”) associated with the patient.

In one embodiment, the method includes monitoring a repository for anindication that at least one image has arrived. At least one image isreceived from the repository. Metadata is extracted from the at leastone image and is used to identify at least one patient. The at least oneimage and the corresponding metadata are associated with an EMR for theat least one patient. At least one image is displayed in the EMR for theat least one patient.

In one embodiment, at least one image of a patient is received. Apatient attributed is extracted from the at least one image and a phototype is identified based on the photo attribute. The at least one imageis sorted utilizing the patient attribute, a patient identification, ora combination thereof. At least one image is displayed in the EMRassociated with the patient.

In one embodiment, at least one image of a patient is acquired from animage capturing device. A body part associated with the at least oneimage is identified as a tag. The tag is stored as metadata associatedwith the at least one image. The at least one image is indexed accordingto the tag. After a tag is selected for reviewing a body area, the atleast one selected image for the selected tag is displayed.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

The present invention is described in detail below with reference to theattached drawing figures, wherein:

FIG. 1 is a block diagram of an exemplary computing system suitable foruse in implementing embodiments of the present invention;

FIG. 2 schematically shows a network environment suitable for performingembodiments of the invention

FIG. 3 is a flow diagram showing an exemplary method for populating anat least one field with metadata for association with at least oneimage, in accordance with an embodiment of the present invention;

FIG. 4 is a flow diagram showing an exemplary method for communicating aprotocol to an image capturing device, in accordance with an embodimentof the present invention;

FIG. 5 is a flow diagram showing an exemplary method for receiving aprotocol for capturing at least one image of a patient, in accordancewith an embodiment of the present invention;

FIG. 6 is a flow diagram showing an exemplary method for receivingimages from a repository and associating the images with an EMR for atleast one patient, in accordance with an embodiment of the presentinvention;

FIG. 7 is a flow diagram showing an exemplary method for sorting anddisplaying images according to a patient attribute and/or a patientidentifier in accordance with an embodiment of the present invention;and

FIG. 8 is a flow diagram showing an exemplary method for indexing atleast one image, in accordance with an embodiment of the presentinvention.

DETAILED DESCRIPTION

The subject matter of the present invention is described withspecificity herein to meet statutory requirements. However, thedescription itself is not intended to limit the scope of this patent.Rather, the inventors have contemplated that the claimed subject mattermight also be embodied in other ways, to include different steps orcombinations of steps similar to the ones described in this document, inconjunction with other present or future technologies. Moreover,although the terms “step” and/or “block” may be used herein to connotedifferent components of methods employed, the terms should not beinterpreted as implying any particular order among or between varioussteps herein disclosed unless and except when the order of individualsteps is explicitly described.

Embodiments of the present invention provide systems, methods, andcomputer-readable media having computer-executable instructions embodiedthereon for protocol driven image acquisition, populating an EMR withimages, and beginning structured documentation on an image capturingdevice. An exemplary operating environment is described below, thoughone of ordinary skill in the art will appreciate that other suitableoperating environments may be used.

Referring now to the drawings in general, and initially to FIG. 1 inparticular, an exemplary computing system environment, for instance, amedical information computing system, on which embodiments of thepresent invention may be implemented is illustrated and designatedgenerally as reference numeral 20. It will be understood and appreciatedby those of ordinary skill in the art that the illustrated medicalinformation computing system environment 20 is merely an example of onesuitable computing environment and is not intended to suggest anylimitation as to the scope of use or functionality of the invention.Neither should the medical information computing system environment 20be interpreted as having any dependency or requirement relating to anysingle component or combination of components illustrated therein.

Embodiments of the present invention may be operational with numerousother general purpose or special purpose computing system environmentsor configurations. Examples of well-known computing systems,environments, and/or configurations that may be suitable for use withthe present invention include, by way of example only, personalcomputers, server computers, hand-held or laptop devices, multiprocessorsystems, microprocessor-based systems, set top boxes, programmableconsumer electronics, network PCs, minicomputers, mainframe computers,distributed computing environments that include any of theabove-mentioned systems or devices, and the like.

Embodiments of the present invention may be described in the generalcontext of computer-executable instructions, such as program modules,being executed by a computer. Generally, program modules include, butare not limited to, routines, programs, objects, components, and datastructures that perform particular tasks or implement particularabstract data types. Embodiments of the present invention may also bepracticed in distributed computing environments where tasks areperformed by remote processing devices that are linked through acommunications network. In a distributed computing environment, programmodules may be located in local and/or remote computer storage mediaincluding, by way of example only, memory storage devices.

With continued reference to FIG. 1, the exemplary medical informationcomputing system environment 20 includes a general purpose computingdevice in the form of a server 22. Components of the server 22 mayinclude, without limitation, a processing unit, internal system memory,and a suitable system bus for coupling various system components,including database cluster 24, with the server 22. The system bus may beany of several types of bus structures, including a memory bus or memorycontroller, a peripheral bus, and a local bus, using any of a variety ofbus architectures. By way of example, and not limitation, sucharchitectures include Industry Standard Architecture (ISA) bus, MicroChannel Architecture (MCA) bus, Enhanced ISA (EISA) bus, VideoElectronic Standards Association (VESA) local bus, and PeripheralComponent Interconnect (PCI) bus, also known as Mezzanine bus.

The server 22 typically includes, or has access to, a variety ofcomputer readable media, for instance, database cluster 24. Computerreadable media can be any available media that may be accessed by server22, and includes volatile and nonvolatile media, as well as removableand non-removable media. By way of example, and not limitation, computerreadable media may include computer storage media and communicationmedia. Computer storage media may include, without limitation, volatileand nonvolatile media, as well as removable and nonremovable mediaimplemented in any method or technology for storage of information, suchas computer readable instructions, data structures, program modules, orother data. In this regard, computer storage media may include, but isnot limited to, RAM, ROM, EEPROM, flash memory or other memorytechnology, CD-ROM, digital versatile disks (DVDs) or other optical diskstorage, magnetic cassettes, magnetic tape, magnetic disk storage, orother magnetic storage device, or any other medium which can be used tostore the desired information and which may be accessed by the server22. Communication media typically embodies computer readableinstructions, data structures, program modules, or other data in amodulated data signal, such as a carrier wave or other transportmechanism, and may include any information delivery media. As usedherein, the term “modulated data signal” refers to a signal that has oneor more of its attributes set or changed in such a manner as to encodeinformation in the signal. By way of example, and not limitation,communication media includes wired media such as a wired network ordirect-wired connection, and wireless media such as acoustic, RF,infrared, and other wireless media. Combinations of any of the abovealso may be included within the scope of computer readable media.

The computer storage media discussed above and illustrated in FIG. 1,including database cluster 24, provide storage of computer readableinstructions, data structures, program modules, and other data for theserver 22. For example, the database cluster 24 can contain electronicclinical documents capable of receiving multiple types of input,including images, dictation audio input, structured user input,free-text input, and system-generated input. Database cluster 24 cancontain electronic medical records for various patients. Data from theserecords can be used by the system to generate system-generated input tobe populated into sections of electronic clinical documents. Forexample, images of a patient that may have been captured or storedelsewhere in the system, such as on an image capturing device (notshown), may be populated by the system into an electronic notedocumenting a particular patient encounter. Further, forms forsupporting structured user input may also be generated, at least inpart, on the image capturing device itself and stored in databasecluster 24, and may be customized by a particular health care provideror institution. And, electronic clinical documents that have beenpopulated with various forms of input can be stored in database cluster24.

The server 22 may operate in a computer network 26 using logicalconnections to one or more remote computers 28. Remote computers 28 maybe located at a variety of locations in a medical or researchenvironment, for example, but not limited to, clinical laboratories,hospitals and other inpatient settings, veterinary environments,ambulatory settings, medical billing and financial offices, hospitaladministration settings, home health care environments, and clinicians'offices. Clinicians may include, but are not limited to, a treatingphysician or physicians, specialists such as surgeons, radiologists,cardiologists, and oncologists, emergency medical technicians,physicians' assistants, nurse practitioners, nurses, nurses' aides,pharmacists, dieticians, microbiologists, laboratory experts, geneticcounselors, researchers, veterinarians, students, and the like. Theremote computers 28 may also be physically located in non-traditionalmedical care environments so that the entire health care community maybe capable of integration on the network. The remote computers 28 may bepersonal computers, servers, routers, network PCs, peer devices, othercommon network nodes, or the like, and may include some or all of thecomponents described above in relation to the server 22. The devices canbe personal digital assistants or other like devices.

Exemplary computer networks 26 may include, without limitation, localarea networks (LANs) and/or wide area networks (WANs). Such networkingenvironments are commonplace in offices, enterprise-wide computernetworks, intranets, and the Internet. When utilized in a WAN networkingenvironment, the server 22 may include a modem or other means forestablishing communications over the WAN, such as the Internet. In anetworked environment, program modules or portions thereof may be storedin the server 22, in the database cluster 24, or on any of the remotecomputers 28. For example, and not by way of limitation, variousapplication programs may reside on the memory associated with any one ormore of the remote computers 28. It will be appreciated by those ofordinary skill in the art that the network connections shown areexemplary and other means of establishing a communications link betweenthe computers (e.g., server 22 and remote computers 28) may be utilized.

In operation, a user may enter commands and information into the server22 or convey the commands and information to the server 22 via one ormore of the remote computers 28 through input devices, such as akeyboard, a pointing device (commonly referred to as a mouse), atrackball, or a touch pad. Other input devices may include, withoutlimitation, image capturing devices, microphones, satellite dishes,scanners, or the like. Commands and information may be sent directlyfrom a remote healthcare device to the server 22. In accordance withvarious embodiments of the present invention, commands and informationmay also be sent directly from an image capturing device to the server22, and vice versa. In addition to a monitor, the server 22 and/orremote computers 28 may include other peripheral output devices, such asspeakers and a printer.

Although many other internal components of the server 22 and the remotecomputers 28 are not shown, those of ordinary skill in the art willappreciate that such components and their interconnections are wellknown. Accordingly, additional details concerning the internalconstruction of the server 22 and the remote computers 28 are notfurther disclosed herein.

Any type of image capturing device, such as the Ricoh Caplio 500 SE, maybe used to capture images to be associated with metadata and embeddedinto electronic clinical documents. Additionally, images may be receivedby an external image capturing device and then communicated to a remotecomputer 28 or into the control server 22. For example, a photographercan capture images of a patient with an image capturing device.Information may be added as metadata of and associated with the image.The image can then be communicated to a remote computer 28 or thecontrol server 22. The image and associated metadata can then beembedded into an electronic clinical document, as more fully describedbelow.

The electronic clinical document can be provided via any type ofgraphical display, such as a computer monitor or any other type ofgraphical presentation apparatus, such as for example, an LCD screen, alaptop display, or a handheld PDA device. An electronic clinicaldocument can be any type of electronic medical documentation relevant toa particular patient and can be part of an electronic healthcareinformation technology system. An electronic clinical document can alsobe a clinical event document relating to a particular clinical event fora patient, including, by way of example only, a patient visit orencounter. By way of example and not limitation, electronic clinicaldocuments may be images, clinical notes, summaries, reports, analyses,or other types of electronic medical documentation relevant to aparticular patient's condition and/or treatment. Electronic clinicaldocuments contain various types of information relevant to the conditionand/or treatment of a particular patient and can include informationrelating to, for example, patient identification information, images,physical examinations, vital signs, past medical histories, surgicalhistories, family histories, histories of present illnesses, current andpast medications, allergies, symptoms, past orders, completed orders,pending orders, tasks, lab results, other test results, patientencounters and/or visits, immunizations, physician comments, nursecomments, other caretaker comments, and a host of other relevantclinical information. Electronic clinical documents may be stored withinan overall electronic medical chart or electronic medical recordassociated with a patient.

The format for electronic clinical documents may be customized by theuser and/or may be established by a particular healthcare institution,such as by using a profile stored in a database, such as databasecluster 24, or by using a locally stored profile on a remote computer(e.g., remote computer 28 of FIG. 1).

“Image”, as the term is utilized herein, refers to any type of image(for example, digital photographs, x-rays, ultrasound, and the like)that is captured for the purpose of creating a visual record ofinformation for a patient that can be associated with the electronicclinical document. Clinicians, for example, frequently order images tomemorialize relevant image-related information associated with patientinteractions, diagnoses, and intended treatment plans. In embodiments ofthe present invention, images are stored in an electronic format. Anyelectronic format can be used. Compressed or uncompressed formats can beused and are contemplated as being within the scope of embodiments ofthe present invention. In other embodiments, images can be stored in anelectronic file, transferred to or imported into a medical informationsystem, and then embedded into an electronic clinical document. Any andall such variations and combinations thereof, are contemplated to bewithin the scope of embodiments hereof.

Typically, if a physician or other provider has additional documentationto add relevant to the image, there is not immediate access to the imagefile. As such, if the physician desires to review, edit or add to theimage related information, the physician must wait until the image isuploaded and directed to the appropriate electronic medical record,which is inefficient and frustrating. However, the image capturingdevice of the present invention is capable of beginning structureddocumentation. For example, a clinical form or table which providespredefined structure designed for receiving user input relevant toparticular aspects of a patient's condition and/or treatment may be usedin accordance with embodiments of the present invention. The particularstructure used to guide the user's input is communicated to the imagecapturing device. In embodiments, the structure is communicated viabarcode, a memory device, wireless communication, or a combinationthereof. The structure defines at least one field, such that informationrelevant to the particular image is documented. The photographer isprompted, in one embodiment, to input information that is associatedwith the image as metadata. Any type of clinical information relevant tothe patient may be received via structured user input provided that aparticular field that is capable of capturing the information iscommunicated to the image capturing device. As mentioned briefly, theinformation may be stored as metadata. In one embodiment, at least aportion of the information is stored in an exchangeable image fileformat (EXIF) header. In one embodiment, at least a portion of theinformation is stored in the filename.

Referring now to FIG. 2, a block diagram is provided illustrating anexemplary system 200 in which an image acquisition server 220 is shownconnected by a network 210 to an an image capturing device 230, EMR 240,and a remote computer 250, in accordance with an embodiment of thepresent invention. The image acquisition server 220 may be part of acomprehensive computing system within a clinical environment similar tothe exemplary computing system 20 discussed above with reference to FIG.1.

The image acquisition server 220 may include a database (not shown)storing data communicated by the image acquisition device 230. The imageacquisition server 220 is comprised of various components, including amonitoring component, a receiving component, an extraction component, anidentification component, a storing component, and a displayingcomponent. The monitoring component monitors a repository for at leastone image. When an image arrives in the repository, the receivingcomponent receives the image for further processing. An extractioncomponent extracts metadata associated with the image. The extractioncomponent, in one embodiment, also extracts information from the fileheader. In another embodiment, the extraction component extractsinformation from the file name. An identification component identifies apatient associated with the metadata and a storing component stores theimage and associated metadata in an EMR for the patient. In oneembodiment, the identification component identifies the patient with themetadata. In one embodiment, the identification component identifies thepatient based on an existing patient to device association. A displayingcomponent displays the image and associated metadata in the EMR. In oneembodiment, the displaying component displays the image and associatedmetadata on a remote computer 250.

In one embodiment, the image acquisition server 220 also includes anencoding component and a communication component. The encoding componentencodes a protocol for capturing at least one image of a patient. Theprotocol is encoded, in one embodiment, in a barcode. The communicationcomponent communicates the encoded protocol to the image capturingdevice.

The image capturing device is comprised of a barcode receivingcomponent, a protocol component, a decoding component, a displayingcomponent, a population component, a capturing component, an associationcomponent, and a communication component. The barcode receivingcomponent receives a barcode encoded with information associated with apatient. Information encoded in the barcode is decoded by the decodingcomponent. The information is utilized to begin structureddocumentation. The protocol receiving component receives a protocol forcapturing at least one image of the patient. The protocol comprisesorders from a practitioner, a workflow for capturing the at least oneimage, or a combination thereof. In one embodiment, the protocol isencoded in the barcode and the protocol component receives the protocolfrom the decoding component. The displaying component displays theprotocol for capturing the at least one image of the patient. At leastone field is populated with metadata corresponding to the patient withthe population component. The capturing component captures the at leastone image and the association component associates the metadata with theat least one image. The at least one image and associated metadata iscommunicated to an electronic medical record associated with the patientby the communication component.

With reference to FIG. 3, an exemplary flow diagram representative of amethod for populating an at least one field with metadata forassociation with at least one image in accordance with an embodiment ofthe present invention is shown and referenced generally by referencenumeral 300. Method 300 may be implemented using the above-describedexemplary computing system environment (FIG. 1) and, by way of exampleonly, may be utilized by a clinician to populate an electronic clinicaldocument (e.g., an electronic medical record) associated with a patient.The terms “individual”, “person”, and “patient” are used interchangeablyherein and are not meant to limit the nature of the referencedindividual in any way. Rather, the methods and systems described hereinare equally applicable in, for instance, a veterinary setting. Further,use herein of the term “patient” is not meant to imply any particularrelationship between the individual in question and those populating anelectronic clinical document associated with the individual.

Initially, as shown at step 310, a barcode associated with a patient isdecoded. In one embodiment, an image capturing device includes thenecessary components to decode the barcode. The barcode may be invarious formats, such as two dimensional or three dimensional. Inanother embodiment, the barcode is decoded by a component of the medicalinformation system described in FIG. 1 and the resulting decodedinformation is communicated to the image capturing device. Various formsof communication may be utilized, such as via wireless communicationbetween the decoding component of the medical information system and theimage capturing device, via Universal Serial Bus (USB) or similarcommunication, via a memory device such as a Secure Digital (SD) card,or any other method of communication for transmitting information to orfrom a peripheral device, such as the image capturing device of thisexample, and a computing system, such as a server or remote computer. Inone embodiment, the image capturing device is in two-way communicationwith the medical information system.

The barcode includes information associated with the patient. In oneembodiment, the information includes patient identifying information. Atstep 320, at least one field is populated with metadata derived from theinformation. Accordingly, structured documentation is beginning prior tocapturing an image that can be associated, and amended as necessary,with an image. At least one image of the patient is captured, at step330. Metadata, at step 340, is associated with the at least one image.The image and associated metadata is communicated, in one embodiment, toan EMR associated with the patient. In one embodiment, a field of the atleast one field is a placeholder for a tag. The tag is used, in oneembodiment, to describe the body part or body parts associated with theimage. In one embodiment, the tag is received by barcode, a memorydevice, wireless communication, manual input, or a combination thereof.

In one embodiment, a protocol is received by the image capturing device.The protocol is received, in various embodiments, by any of the forms ofcommunication described herein, including via barcode. The protocol, inone embodiment, comprises orders from a clinician. The orders provide adetermination from or authorization by a clinician that at least oneimage of a patient needs to be captured. In one embodiment, the protocolcomprises a workflow for capturing at least one image. The workflowprovides instructions to the photographer to capture the at least oneimage corresponding to the clinician's orders. The instructions mayfurther provide details regarding information that should be associatedwith an image. The information may be inputted manually by thephotographer into the image capturing device (or any device orperipheral associated with the medical information system) by any formof communication already disclosed.

In one embodiment, a dictionary is received. The dictionary defines astructure for the at least one field. In one embodiment, the dictionaryfurther comprises a protocol. The protocol comprises orders from apractitioner, a workflow for capturing the at least one image, or acombination thereof. In various embodiments, the dictionary is receivedby barcode, a memory device, by wireless communication, or a combinationthereof.

Referring now to FIG. 4, an exemplary flow diagram representative of amethod for communicating a protocol to an image capturing device inaccordance with an embodiment of the present invention is shown andreferenced generally by reference numeral 400. Method 400 may beimplemented using the above-described exemplary computing systemenvironment (FIG. 1) and, by way of example only, may be utilized forprotocol driven image acquisition.

Initially, as shown at step 410, a protocol is communicated to an imagecapturing device for taking at least one image of a patient. Theprotocol comprises orders from a practitioner, a workflow for capturingthe at least one image, or a combination thereof. As briefly describedabove, the image capturing device is a digital camera, a handheldscanner, or any other imaging device that may be used to capture medicalimages. At step 420, metadata is associated with the at least one image.The metadata, in various embodiments, is patient identifying informationor documentation for clinical or non-clinical purposes relevant to theparticular image, and is used to begin structured documentationassociated with the image for the patient's EMR. The medical informationsystem receives the at least one image and associated metadata, at step430. A stored patient is identified corresponding to the at least oneimage and associated metadata. At step 440, the at least one image andassociated metadata is stored in an electronic medical record for thepatient.

In one embodiment, a dictionary is communicated to the image capturingdevice. In various embodiments, the dictionary is communicated bybarcode, wireless communication, a memory device, or a combinationthereof. The dictionary defines a structure for at least one field forreceiving the metadata. Receipt of metadata into the at least one fieldbegins the structured documentation, and once communicated to theelectronic medical record, it will be received into the electronicclinical document as defined by the structure. In one embodiment, thedictionary further comprises a workflow. In one embodiment, one field ofthe at least one field is a tag for describing the body part associatedwith the image. The tag allows the image to be indexed according to bodypart. The tag further allows the image to be embedded appropriately inthe electronic clinical document. For example, the electronic clinicaldocument may include a silhouette of a human body. The clinician maywish to review any images received by the medical information system forthat particular clinical document. Any images with a tag are embeddedand appear within the appropriate portion of the silhouette. In oneembodiment, the image capturing device is in two-way communication witha medical information system.

In one embodiment, receiving the at least one image and associatedmetadata in an electronic medical record associated with the patientcomprises monitoring a repository for the at least one image andassociated metadata. Once the medical information system detects that anew image was received into the repository, the system compares themetadata associated with the at least one image with stored metadatastored in the medical information system. A patient is identified thatis associated with the metadata. The at least one image and associatedmetadata is then transferred to the electronic medical record of thepatient.

Referring now to FIG. 5, an exemplary flow diagram representative of amethod for receiving a protocol for capturing at least one image of apatient, in accordance with an embodiment of the present invention isshown and referenced generally by reference numeral 500. Method 500 maybe implemented using the above-described exemplary computing systemenvironment (FIG. 1) and, by way of example only, may be utilized forprotocol driven image acquisition.

Initially, as shown at step 510, a protocol for capturing at least oneimage of a patient is received. The protocol comprises orders from apractitioner, a workflow for capturing the at least one image, or acombination thereof. Information associated with the patient isreceived, at step 520. The information is utilized to begin structureddocumentation. At step 530, a protocol is displayed for capturing the atleast one image of the patient. At least one field is populated, at step540, with metadata corresponding to the patient. The metadata isassociated with the at least one image at step 550. At step 560, the atleast one image and associated metadata is transmitted to an electronicmedical record associated with the patient. In one embodiment, aphotographer is prompted to input additional information to beassociated with the at least one image.

Referring now to FIG. 6, an exemplary flow diagram representative of amethod for receiving images from a repository and associating the imageswith an EMR for at least one patient, in accordance with an embodimentof the present invention is shown and referenced generally by referencenumeral 600. Method 600 may be implemented using the above-describedexemplary computing system environment (FIG. 1) and, by way of exampleonly, may be utilized to prepopulate clinical events with image baseddocumentation.

Initially, as shown at step 610, a repository is monitored for anindication that at least one image has been received. At step 620, theimage is received from the repository. Metadata is extracted from the atleast one image at step 630. At least a portion of the metadata isincluded in an EXIF header, in one embodiment. In another embodiment, atleast a portion of the metadata is included in the filename. At leastone patient is identified, at step 640, with the metadata. At step 650,the at least one image and the corresponding metadata is associated withan electronic medical record for the at least one patient. The at leastone image is displayed in the electronic medical record for the at leastone patient at step 660.

In one embodiment, a body part associated with the at least one image isidentified. In one embodiment, a tag is defined for the at least oneimage. The tag describes the body part associated with the at least oneimage and can be used to embed or receive an image within a silhouettein the electronic clinical document. In one embodiment, the tag isstored as metadata of the at least one image.

In one embodiment, clinical documentation is received to associate withthe at least one image. The clinical documentation is stored as metadatain any of the forms already described herein. The clinical documentationmay include notes from a clinician that were communicated to an imagecapturing device to be associated with at least one image, documentationfrom the photographer, and documentation received via barcode, wirelesscommunication, or memory device.

In embodiments, displaying the at least one image in the electronicmedical record comprises identifying a body part associated with the atleast one image. A tag is defined for the at least one image and storedas metadata. In one embodiment, the at least one image is indexedaccording to the body part and displayed according to the index. Inanother embodiment, searching is enabled for at least one imageaccording to the tag.

In embodiments, the at least one image is stored in a standard format.For example, the image may be a JPG, a GIF, a PDF, or a TIFF. In oneembodiment, the filename comprises information derived from themetadata. In one embodiment, dictation is associated with the at leastone image. In one embodiment, the dictation is available in theelectronic medical record for the at least one patient.

Referring now to FIG. 7, an exemplary flow diagram representative of amethod for sorting and displaying images according to a patientattribute and/or a patient identifier in accordance with an embodimentof the present invention, in accordance with an embodiment of thepresent invention is shown and referenced generally by reference numeral700. Method 700 may be implemented using the above-described exemplarycomputing system environment (FIG. 1) and, by way of example only, maybe utilized to prepopulate clinical events with image baseddocumentation.

Initially, as shown at step 710, at least one image of a patient isreceived. The image may be in any format, such as those alreadydescribed herein. A patient attribute is extracted from the at least oneimage at step 720. The patient attribute includes, in one embodiment, abody part associated with the at least one image. In another embodiment,the patient attribute includes patient identifying information. In yetanother embodiment, the patient attribute includes clinicaldocumentation (as described above). At step 730, a photo type isidentified based on the patient attribute.

The at least one image is stored, at step 740, utilizing the patientattribute and a patient identification. As mentioned briefly above, thepatient identification is derived, in one embodiment, from the patientattribute. In one embodiment, the at least one image is stored in astandard format and the filename comprises the metadata (or at least aportion thereof). In one embodiment, dictation is associated with the atleast one image. At step 750, the at least one image is displayed in anelectronic medical record associated with the patient.

In one embodiment, a tag is defined for the at least one image. The tagdescribes the body part associated with the at least one image. In oneembodiment, the tag is stored as metadata of the at least one image. Asdescribed above, the tag allows the image to be depicted as part of asilhouette in the electronic medical record and allows the clinician toquickly identify images associated with a particular body part.

In one embodiment, displaying the at least one image in the electronicmedical record comprises indexing the at least one image, enablingsearching for the at least one image according to an index, displayingthe at least one image according to the index, or a combination thereof.

Referring now to FIG. 8, an exemplary flow diagram representative of amethod for indexing at least one image, in accordance with an embodimentof the present invention is shown and referenced generally by referencenumeral 800. Method 800 may be implemented using the above-describedexemplary computing system environment (FIG. 1) and, by way of exampleonly, may be utilized to prepopulate clinical events with image baseddocumentation.

Initially, as shown at step 810, at least one image of a patient isacquired from an image capturing device. At step 820, a body partassociated with the at least one image is identified as a tag. The tagis stored as metadata associated with the at least one image at step830. The at least one image is indexed, at step 840, according to thetag. At step 850, a tag is selected for reviewing a body area. At leastone selected image is displayed according to the selected tag at step860. In one embodiment, clinical documentation to be associated with theat least one image is received.

As can be understood, the present invention provides systems, methods,and user interfaces for protocol driven image acquisition. The presentinvention has been described in relation to particular embodiments,which are intended in all respects to be illustrative rather thanrestrictive. Alternative embodiments will become apparent to those ofordinary skill in the art to which the present invention pertainswithout departing from its scope.

From the foregoing, it will be seen that this invention is one welladapted to attain all the ends and objects set forth above, togetherwith other advantages which are obvious and inherent to the system andmethod. It will be understood that certain features and subcombinationsare of utility and may be employed without reference to other featuresand subcombinations. This is contemplated and within the scope of theclaims.

What is claimed is:
 1. One or more computer storage devices havingcomputer-executable instructions embodied thereon, that when executed,perform a method of prepopulating clinical events with image baseddocumentation, the method comprising: providing, via an electronicmedical record, a silhouette of a human body to a clinician device, thesilhouette of the human body being a graphical representation of thehuman body; receiving, on the clinician device, a selection of a tagembedded at a location on the silhouette of the human body, the tagcorresponding to a body part represented by the silhouette at thelocation; and based on the selection, displaying the image andassociated clinical documentation on the clinician device.
 2. The mediaof claim 1, wherein the tag describes the body part associated with theimage.
 3. The media of claim 1, wherein the clinical documentationincludes notes from a clinician that were communicated to an imagecapturing device to be associated with the image.
 4. The media of claim1, wherein the clinical documentation includes documentation from aphotographer.
 5. The media of claim 1, wherein the clinicaldocumentation includes documentation received via barcode, wirelesscommunication, or memory device.
 6. The media of claim 1, furthercomprising enabling searching, utilizing the tag, for the image.
 7. Themedia of claim 1, wherein dictation is associated with the image.
 8. Amethod of prepopulating clinical events with image based documentation,the method comprising: providing, via an electronic medical record, asilhouette of a human body to a clinician device, the silhouette of thehuman body being a graphical representation of the human body;receiving, on the clinician device, a selection of a tag embedded at alocation on the silhouette of the human body, the tag corresponding to abody part represented by the silhouette at the location; and based onthe selection, displaying the image and associated clinicaldocumentation on the clinician device.
 9. The method of claim 8, whereinthe tag describes the body part associated with the image.
 10. Themethod of claim 8, wherein the clinical documentation includes notesfrom a clinician that were communicated to an image capturing device tobe associated with the image.
 11. The method of claim 8, wherein theclinical documentation includes documentation from a photographer. 12.The method of claim 8, wherein the clinical documentation includesdocumentation received via barcode, wireless communication, or memorydevice.
 13. The method of claim 8, further comprising enablingsearching, utilizing the tag, for the image.
 14. The method of claim 8,further comprising wherein dictation is associated with the image.
 15. Acomputerized system for prepopulating clinical events with image baseddocumentation, the system comprising: a processor; and a computerstorage medium storing computer-usable instructions that, when used bythe processor, cause the processor to: provide, via an electronicmedical record, a silhouette of a human body to a clinician device, thesilhouette of the human body being a graphical representation of thehuman body; receive, on the clinician device, a selection of a tagembedded at a location on the silhouette of the human body, the tagcorresponding to a body part represented by the silhouette at thelocation; and based on the selection, display the image and associatedclinical documentation on the clinician device.
 16. The system of claim15, wherein the tag describes the body part associated with the image.17. The system of claim 15, wherein the clinical documentation includesnotes from a clinician that were communicated to an image capturingdevice to be associated with the image.
 18. The system of claim 15,wherein the clinical documentation includes documentation from aphotographer.
 19. The system of claim 15, wherein the clinicaldocumentation includes documentation received via barcode, wirelesscommunication, or memory device.
 20. The system of claim 15, furthercomprising enabling searching, utilizing the tag, for the image.